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Memory Loss

&. The GP. Marijke Boers . Church St Surgery . April 2017. Role of the G. P.. Is this NORMAL age related memory loss. OR…..Something Else…... REFERENCE: Having a Senior Moment ?. Best Practice Journal of BPAC NZ WEBSITE.

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Memory Loss






Presentation on theme: "Memory Loss"— Presentation transcript:

Slide1

Memory Loss&The GP

Marijke Boers

Church St Surgery

April 2017Slide2

Role of the G. P.Is this NORMAL age related memory loss

OR…..Something Else…..

REFERENCE: Having a Senior Moment ?

Best Practice Journal of BPAC NZ WEBSITE

Number 36, Issue 23Slide3

We All Have Age Related Memory LossStarts in our 20’s

Accelerates from age 50

Neurones Reduce, Brain volume shrinks, synapses less efficient

Names/words/laying down new information

Genetics, hormones, other illness, environmental factors Slide4

4 Types of Memory

Episodic Memory- For significant events

Learning and recall Declines from middle age

Semantic Memory – factual and conceptual knowledge

Volume increases from middle age to young elderly, then declines

Procedural Memory- how to of skills and procedures…

normally retained into late life

Working memory – learning new information, retaining and then manipulating it-

eg

- following a map, new person’s name, learning a new procedure…

with age, the span often becomes shorterSlide5

Mild

Frequently Misplaces Items

Forgets names , slow to recall them

Word finding difficulties

Forget recent events or newly learned information

Temporarily becomes lost, trouble understanding or following a map

Worries about memory loss. Friends and family are noticing

Dementia

Forgets use of an item, or puts in wrong place

Forgets knowing someone

Begins to lose language skills

Loses sense of time, not sure what day it is

Working memory seriously impaired. Difficulty learning or remembering new information

Becomes easily disorientated or lost in familiar places

Little or now awareness of thinking /problem solving difficultiesSlide6

1. Confirm Memory and Thinking Problems Memory Tests

Family Informant Questionnaire

(Helpful to have information from family and loved ones)

Consider repeating, different times, different questionnaires or versions of a questionnaireSlide7

2. Rule out other causes

Infections

Heart or Breathing problems

Nutritional or Hormonal (

eg

Diabetes)

Mood or anxiety problems

…. So , MUST

I

NCLUDE

A physical examinationBlood Tests Slide8

Once Cognitive Impairment ConfirmedAny REVERSIBLE Causes ?- FIX THOSE

Check Safety at home, driving,

etc

See if patient needs support in their home- REFER to ICM or support services

If Mild, attend to diet, lifestyle, stimulation

If moderate, Consider CHOLINE ESTERASE INHIBITOR- or similarSlide9

CHOLINESTERASE INHIBITOR, BPJ Issue 30, P28

Acetyl Choline- important in brain for memory and other functions

Medication MAY be helpful in moderate or advanced

Alzheimers

…. Slows decline or even brief improvement

Does not

prevent

Decline, Sadly

Discuss Pros and Cons, consider side effects (Nausea , slowed heart rate, slow to wee…)

Side effects short lived, dose dependent

Monitor response carefully, get Specialist input , wean off when no longer helpful